Allergic Rhinitis (Hay Fever and Rose Fever) and Chronic Nasal Congestion

Description

Alternative Names

Prevention

People with existing allergies should avoid irritants or allergens, which may include one or more of the following:

• Pollen. This is the primary cause of allergic rhinitis.
• Dust mites, specifically mite feces, which are coated with enzymes that contain a powerful allergen. These are the primary allergens inside the home.
• Animal dander (flakes of skin) and hair, including from cats, house mice, and dogs. House mice are proving to be significant sources of allergens, particularly in urban children.
• Molds.
• Fungi.
• Cockroaches are major asthma triggers and may reduce lung function even in people without a history of asthma.
• In adults, some research suggests that alcohol intake may influence allergy severity. One Spanish study found that as little as one drink a day is enough to worsen dust mite allergies.
• It is important to note that studies are now suggesting that early exposure to some of these allergens, including dust mites and pets, may prevent allergies from developing in children in the first place.

Indoor Protection Against Allergens

Some experts believe that reducing the risk factors for asthma in the home could reduce asthma in children by 40%.

Controlling Pets. People with asthma who already have pets and are not allergic to them probably have a low risk for developing such allergies later on. In fact, when children are exposed to more than one dog or cat during their first year, they have a much lower risk for not only for pet allergies but seasonal allergies and asthma as well. (Pet exposure does not protect them from other allergens, notably dust mites and cockroaches).

In children who have an existing allergy to pets, however, the pets should be given away or kept outside. If this isn't possible, they should at least be confined to carpet-free areas outside the bedroom. Cats harbor significant allergens, which can even be carried on clothing; dogs usually present fewer problems. Washing animals once a week can reduce allergens. Dry shampoos, such as Allerpet, are now available for both cats and dogs that remove allergens from skin and fur and are easier to administer than wet shampoos.

For small children, stuffed animals might serve as a comforting replacement, although they might harbor dust mites. Putting stuffed animals in the freezer for 24 hours before washing them kills the dust mites. For best effect, this process should be done weekly.

Preventing Exposure to Cigarette and Cooking Smoke. Parents who smoke are strongly urged to make strenuous efforts to quit. Studies are finding that exposure to second-hand smoke in the home increases the risk for asthma and asthma-related emergency room visits in children. And, just smoky cooking can worsen asthma. [For help in quitting, see the Well-Connected Report # 41, Smoking.]

Controlling for Dust. A 2002 study reported that simply using a spray furniture polish is very effective for reducing both dust and allergens. Air cleaners, filters for air conditioners, and vacuum cleaners with HEPA filters can help remove particles and small allergens found indoors. Neither vacuuming nor the use of anti-mite carpet shampoo, however, is effective in removing mites in house dust. In fact, vacuuming stirs up both mites and cat allergens. Carpets and rugs should be avoided if possible.

Bedding and Curtains. Using semipermeable coverings to fully encase mattresses and pillows is the most proven effective step in reducing dust mite levels. (Vinyl mattress covers limit airflow and may also exacerbate, or even cause, asthma in children. Synthetic pillows may pose a significantly higher risk for severe asthma attacks in children than feather or no pillows, although well-conducted studies are needed to confirm this.) Curtains should be replaced with shades or blinds and bedding washed using the highest temperature setting.

One 1999 study found that children sleeping in bottom bunk beds are significantly more likely to develop asthma than siblings occupying the upper bunks. Families with asthmatic or allergic children should avoid bunk beds or be sure that children with asthma sleep in the top bunk. Even with standard beds, it may be useful to have them sleep as high off the floor as possible.

Reducing Humidity in the House. Although warm, moist air from vaporizers can greatly ease and moderate asthma attacks, living in a damp house is counter productive. Dust mites thrive in humidity and damp houses increase the risk for mold. On-going humidifiers, then, can be counterproductive. If they are used, humidity levels should not exceed 40% and they should be cleaned daily with a vinegar solution.

Exterminating Pests (Cockroaches and Mice). Cockroaches should be eliminated by professional exterminators. (One study reported that ridding a home of cockroaches and cleaning the house using standard housecleaning techniques failed to eliminate the cockroach allergens themselves.) Mice should be eliminated, and attempts should be made to remove all dust, which might contain mouse urine and dander.

Outdoor Protection

Avoiding Outdoor Allergens. The following are some recommendations for avoiding allergens outside:

• Camping and hiking trips should not be scheduled during times of high pollen count (in the Northern states, May and June for grass pollen and mid-August to October for ragweed).
• Patients who are allergic to mold should avoid barns, hay, raking leaves, and mowing grass. Exposure to automobile fumes may worsen asthma. Fungi in car air conditioners can also be a problem.

Dietary Factors

Some evidence that suggests that people with allergic rhinitis and asthma may benefit from a diet rich in omega-3 fatty acids (found in fish, almonds, walnuts, pumpkin, and flax seeds) and fruits and vegetables (at least five servings a day). Some studies also suggest reducing sodium, transfatty acids (hydrogenated fats found in commercial products and baked goods), and omega-6 fatty acids (found in most vegetable oils). Investigators are also studying probiotics--so-called good bacteria, such as lactobacillus and bifidobacterium, which can be obtained in supplements.